丁苯酞注射液对比注射用尤瑞克林治疗中度急性缺血性脑卒中的成本效用分析

Cost effectiveness analysis of butylphthalide and sodium chloride injection versus human urinary kallindinogenase for the treatment of moderate acute ischemic stroke

目的:评价丁苯酞注射液联合常规治疗对比注射用尤瑞克林联合常规治疗中度急性缺血性脑卒中患者的经济性。方法:使用真实世界数据,通过倾向评分匹配的方法对目标患者进行匹配,构建决策树模型进行分析,研究角度为医疗卫生系统角度,研究对象为中度急性缺血性脑卒中的患者。使用成本效用分析对2种治疗药物的经济性进行评价。通过单因素敏感性分析及概率敏感性分析以验证模型的稳健性。结果:对于中度急性缺血性脑卒中的患者,相比于尤瑞克林组,丁苯酞组所获质量调整生命年(QALYs)更多同时成本也较高,短期增量成本效用比为48086元·QALY^(-1),长期增量成本效用比为44983元·QALY^(-1),均小于我国2020年人均GDP(72000元),具有经济性。结论:对于中度急性缺血性脑卒中患者,丁苯酞注射液联合常规治疗相比于注射用尤瑞克林联合常规治疗是更具有经济性的干预方案。

Objective:To evaluate the economics of butylphthalide and sodium chloride injection(NBP)versus human urinary kallindinogenase(HUK)in patients with moderate acute ischemic stroke in China.Methods:A decision tree model from health insurance payer perspective was constructed to evaluate the economics of NBP versus HUK using cost-utility analysis.Efficacy-related data and cost data were collected from real-world data.Before the analysis,patients were matched by propensity scores,which were calculated using baseline characteristics.The robustness of the models was validated by deterministic sensitivity analysis and probabilistic sensitivity analysis.Results:Compared with HUK,NBP resulted in higher QALYs and higher cost for patients with moderate acute ischemic stroke and the incremental cost-effectiveness ratios were￥48086·QALY^(-1)for short term and￥44983·QALY^(-1)for long term,respectively,which were lower than the average GDP per head of China in 2020(￥72000).Conclusion:NBP is economically advantageous in Chinese patients with moderate acute ischemic stroke.